Download The factors influencing transactional sex among

The Factors Influencing
Transactional Sex Among Young
Men and Women in 12 Sub-Saharan
African Countries
Minki Chatterji
Nancy Murray
David London
Philip Anglewicz
October 2004
The Factors Influencing Transactional Sex Among Young Men and Women in
12 Sub-Saharan African Countries
by
Minki Chatterji
Nancy Murray
David London
Philip Anglewicz
October 2004
The POLICY Project is funded by the U.S. Agency for International
Development (USAID) under Contract No. HRN-C-00-00-00006-00,
beginning July 7, 2000. It is implemented by the Futures Group in
collaboration with the Centre for Development and Population Activities
(CEDPA) and Research Triangle Institute (RTI). The views expressed in
this report do not necessarily reflect those of USAID.
ii
Contents
Acknowledgments........................................................................................................................................iv
Introduction................................................................................................................................................... 1
Factors Influencing Transactional Sex Among Adolescents in Sub-Saharan Africa.................................... 1
Methods ........................................................................................................................................................ 2
Results........................................................................................................................................................... 4
Discussion ..................................................................................................................................................... 6
Appendix Tables ........................................................................................................................................... 9
References................................................................................................................................................... 15
iii
Acknowledgments
The authors acknowledge support from the U.S. Agency for International Development and the POLICY
Project’s Adolescent Working Group. We thank Leanne Dougherty for her assistance in preparing the
standard of living indices for the countries included in the analyses presented here. Karen Hardee and Jay
Gribble also provided valuable feedback on an earlier draft of this paper.
iv
Introduction
Anecdotal evidence and several qualitative studies suggest that transactional sex, which is defined as the
exchange of gifts or money for sex, is common among adolescents throughout sub-Saharan Africa
(Bledsoe, 1990; Castle and Konaté, 1999). In situations of transactional sex, young women may be less
able to decide the timing and conditions of sex. Women who have little negotiating power with their
partners to insist on use of condoms experience a higher risk of becoming pregnant and contracting
sexually transmitted infections (STIs), including HIV/AIDS (Gregson et al., 2002; Longfield et al., 2002).
Young men involved in transactional sex may also expose themselves to the risk of STIs.
To begin to protect young men and young women from this heightened risk of HIV/AIDS, it is important
that policymakers and program managers gain a better understanding of transactional sex among youth.
Policymakers and program managers need answers to questions such as: Are youth at higher risk of
engaging in transactional sex than other groups? What factors influence youth to engage in transactional
sex? And, what subgroups of youth are particularly vulnerable to engaging in transactional sex?
This study seeks to answer these questions by exploring whether adolescent boys and girls are at higher
risk for engaging in transactional sex than older men and women by analyzing data from the
Demographic and Health Surveys (DHS) from 12 sub-Saharan African countries including Benin,
Burkina Faso, Central African Republic (CAR), Chad, Guinea, Kenya, Mali, Niger, Nigeria, Togo,
Zambia, and Zimbabwe. We also examine the relationship between young men and young women’s
individual socio-demographic characteristics and the probability that they will engage in the exchange of
sex for money.
Factors Influencing Transactional Sex Among Adolescents in Sub-Saharan Africa
Several qualitative studies explore factors influencing young women to receive money or gifts in
exchange for sex in sub-Saharan Africa. Studies from Cameroon, Kenya, Nigeria, and South Africa find
that young women exchange sex to get funds to cover education-related expenses and gain connections in
social networks (Calves et al., 1996; Barker and Rich, 1992; Kaufman et al., 2001; Meekers and Calves,
1997; Mensch et al., 1998). Other qualitative studies conducted in Cameroon, Ghana, Kenya, Nigeria,
Sierra Leone, Uganda, and Zimbabwe suggest that peer pressure to obtain luxury items, such as
expensive clothing, jewelry, fashionable hairstyles, accessories, and makeup, motivates young women to
engage in transactional sex (Ankomah, 1998; Longfield, 2002; Temin et al., 1999; Bledsoe, 1990; Calves
et al., 1996; Hulton et al., 2000; Nyanzi, 2001; Gregson et al., 2002; Meekers and Calves, 1997;).
Parental pressure emerges as an important issue in qualitative studies conducted in Ghana, Guinea,
Kenya, Sierra Leone, Tanzania, Uganda, and Zimbabwe. The findings from these studies suggest
parental pressure to engage in transactional sex is often implicit rather than explicit, and parents seek to
obtain funds to finance their child’s educational-related expenses, luxury items, and necessities for the
household (Ankomah, 1998; Bledsoe, 1990; Gorgen et al., 1998; Gregson et al., 2002; Hulton et al., 2000;
Longfield et al., 2002; Silberschmidt and Rasch, 2001; Nyanzi et al., 2001) Some research points to
adverse economic conditions as a factor leading young women to engage in transactional sex. However,
according to these studies, extreme poverty is not usually the overriding factor leading young women to
exchange sex for money or gifts (Calves et al., 1996; Nzioka, 2001).
Although some qualitative studies document young men receiving gifts or money in exchange for sex
(Barker and Rich, 1992; Nyanzi et al., 2001; Meekers and Calves, 1997), and young men giving money or
gifts in exchange for sex (Barker and Rich, 1992), our literature search did not locate any qualitative
studies that provided an in-depth analysis of the reasons why young men engage in transactional sex.
1
A few relatively small-scale quantitative studies analyze socio-demographic factors associated with
involvement in transactional sex. Castle and Konate’s (1999) study of young women ages 15–19 in
urban and rural areas of Mali reports that women who classified their relationship as sporadic rather than
leading to marriage were more likely to engage in transactional sex. Being economically well-off, having
multiple partners, having an older partner, having first sex related to an exchange, and having first sex
before age 16 are associated with a young woman being involved in transactional sex. In contrast,
Machel (2001) found that young women attending school in a working class area were more likely to
engage in transactional sex than young women from a high school in a middle class area in Mozambique.
Nzyuko et al.’s (1997) study of young women and men ages 15–19 surveyed at three truck stops in Kenya
suggests that factors such as older age, not being in school, not living with relatives, families not owning
cattle and land, belonging to a larger family, not getting along well with parents, and reporting that
families did not provide adequate food or clothing put young women at a higher risk of engaging in
transactional sex. Factors that appear to put young men in Nzyuko et al.’s (1997) study at higher risk of
engaging in transactional sex include being out of school, older age, and not living with relatives.
Knowledge scores about HIV/AIDS were not associated with engaging in transactional sex for young
men and women in either direction. For young men ages 15–19 in Castle and Konate’s (1999) study,
having a younger partner, having multiple partners, little control of income, and early age of sexual debut
are associated with giving money or gifts for sex.
All of the studies identified in our literature search are based on quantitative and/or qualitative data from
relatively small geographic areas. The contribution of our study is that we analyze population-based DHS
data from 12 sub-Saharan African countries to explore the relationship between men’s and women’s
individual socio-demographic characteristics and the probability that they will engage in transactional
sex. Our analyses permit comparison across different regions within sub-Saharan Africa. Further, we
explore several hypotheses relating to factors associated with transactional sex by analyzing populationbased data with a relatively large sample size.
Our study seeks to answer several questions. First, are young men and women more likely to engage in
transactional sex than older men and women? Prior studies contain many examples of adolescent girls’
involvement in transactional sex, but are adolescent boys more likely to engage in transactional sex than
older men? Qualitative studies suggest peer pressure and a desire to get luxury goods is a motivation for
engaging in transactional sex. Thus, an important question to explore is, are urban youth more likely to
engage in transactional sex than rural youth? Also, are youth who are unmarried or out of school more
likely to engage in transactional sex as we might expect?
This study will explore the relationship
between socioeconomic status and the probability of engaging in transactional sex. While the literature
suggests that most youth are involved in transactional sex not for economic survival, but to get other
goods or services, we assume that young women from less well-off households are more likely to engage
in transactional sex. The literature does not provide much information with regard to the relationship
between young men’s economic status and the likelihood of engaging in transactional sex. Assuming that
most young men involved in transactional sex are giving money or gifts rather than receiving, we
hypothesize that economic status will be positively associated with engagement in transactional sex.
Methods
These analyses use data from the male and female modules from the DHS from 12 sub-Saharan African
countries.1 These 12 datasets are the only DHS that include a question relating to transactional sex. We
include only sexually active women and men in our analyses because the outcome of interest is limited to
those who are sexually active. As seen in Table 1, sexually active men and women constitute
1
Benin (1998), Burkina Faso (1999), Central African Republic (1998), Chad (1997), Guinea (1999), Kenya (1998),
Mali (1996), Niger (1998), Nigeria (1999), Togo (1998), Zambia (1996), and Zimbabwe (1994, women only).
2
approximately 85–90 percent of the original samples of men and women ages 15–49. In the second stage
of the multivariate analysis, only sexually active men and women ages 15–24 are included. This
subgroup includes approximately 30 percent of the sample of sexually active men and women ages 15–
49. The sample sizes available for the two multivariate analyses are shown in Table 2.
There are several limitations of the available data on transactional sex as measured in the DHS.
Information on whether the respondent gave or received the gifts and/or money is not elicited. For these
analyses we assume that of the respondents who answered “yes,” the men gave and the women received
the gift and/or money, but this may be an incorrect assumption. There is no information regarding the
amount of the transaction, or how the respondent interpreted the question (e.g., would a Coke or meal
from a boyfriend qualify as transactional sex?). Respondents in different settings may have interpreted
the question differently, and the variance of these interpretations could influence the validity of this
measure. Additionally, because the data set does not provide information on the age of partner, it is not
possible to directly evaluate the cross-generational aspect of transactional sex. The datasets do not
contain information regarding knowledge of the risks of transactional sex, so we cannot assess the
relationship between this type of knowledge and our outcome of interest.
Proportions of men and women reporting exchange of sex for money or gifts in the last 12 months are
calculated for each of the 12 countries. In Zimbabwe and Central African Republic, the time period is
four weeks instead of 12 months, and in Zimbabwe, men are not included in the analysis. We calculate
proportions of sexually active men and women by the explanatory variables to be used in the multivariate
analysis. These variables include age group, residence, religious affiliation, in-school status, marital
status, and household economic status. Age is recoded into three age groups (15–19, 20–24, and 25+),
and the two categories for residence are urban and rural. As the response categories for religious
affiliation vary somewhat across countries, this variable is recoded into the standard categories of
Christian, Muslim, traditional (where applicable), and “other.”
In-school status is divided into two
groups (in-school and out of school), and marital status is coded as ever-married and never married.
Household economic status is derived from a World Bank Standard of Living index (SLI) that measures
wealth based on household possessions. Households are initially rated based on a 1–5 scale with poorest
households being rated as a 1, and the wealthiest households rated as 5. We combine the two lowest
categories to form a measure of low SLI, the middle level remains as one category, and we collapse the
two highest categories to form a measure of high SLI. These rankings are specific to each country, as the
standard of living of the individuals grouped in the “high” category can be quite different from one
country to another.
We use multivariate methods to further examine relationships between the hypothesized predictor
variables and transactional sex, the outcome of interest. Because the outcome variable is dichotomous
(Have you given or received money, gifts, or favors in return for sex at any time within the last 12
months?2), logistic regression is the multivariate model that is most appropriate to examining the
relationship between transactional sex and the hypothesized associated variables. In the first step of the
analysis, the entire sample of sexually active men and women ages 15–49 are included whereas the
second analysis includes only sexually active men and women ages 15–24.
2
In Central African Republic and Zimbabwe the transactional sex question references the previous four weeks
rather than the past year.
3
Results
Women and Transactional Sex
As shown in Table 3, the proportion of all sexually active women engaging in transactional sex varies
from less than 2 percent in Niger to 11 percent in Zambia. In all but one country (Niger), the proportions
reporting engagement in transactional sex are highest in the 15–19 age group. Higher proportions of
sexually active men report engaging in transactional sex ranging from approximately 5 percent in Guinea
to 24.7 percent in Zambia. As with women, the percent of men engaging in transactional sex is higher in
the younger age groups than among those aged 25 and older.
The results of the initial logistic regression model for all sexually active women 15–49 are presented in
Table 5. In 11 of the 12 countries included in the analysis, the estimated odds of women engaging in
transactional sex are higher among women in the younger age groups than for women 25 years and older;
and in six countries (Benin, Burkina Faso, Mali, Togo, Zambia, and Zimbabwe) this result is statistically
significant at the p < 0.05 level. In the case of Burkina Faso, the model predicts that women ages 15–19
are 400 percent more likely to engage in sexual exchange than women 25 or older. In Mali, Togo, and
Zambia, the model predicts that the odds of women ages 15–19 engaging in transactional sex are more
than 100 percent higher than for women ages 25 years and older, and in Mali, Togo, and Zambia, women
ages 20–24 were also significantly more likely to engage in transactional sex than older women. The odds
ratios are in the expected direction with younger women being more likely to engage in transactional sex
than older women.
Based on the finding that young women are significantly more likely to engage in transactional sex in at
least half the countries included in the initial analyses, we then explore the effects of the other predictor
variables exclusively for young women ages 15–24. Table 6 presents the results of the reduced model for
sexually active 15–24 year old women.
As can be seen in Table 6, while there are some statistically significant relationships between young
women’s residence and whether or not they report transactional sex, the relationship between residence
and the probability of engaging in transactional sex is not consistent across countries. In eight of the 12
countries included in this analysis, young women living in rural areas are significantly less likely to
engage in transactional sex as compared with urban women, and these findings are statistically significant
in three countries (CAR, Kenya, and Mali). However, in Burkina Faso and Nigeria, women living in rural
areas appear to be more likely to be involved in transactional sex, and these findings are statistically
significant.
The role of the religion variable is fairly consistent. In eight of the 12 countries, Muslim women are less
likely to be involved in sexual exchange than women practicing other religions, and this finding is
statistically significant in three countries (CAR, Guinea, and Nigeria).
Surprisingly, young women’s in-school status does not emerge as an important factor in any of the 12
countries in the analysis. As noted in the literature review, in-school status is often associated with a
lower probability of engaging in risky behaviors. However, because of reverse causality, in-school status
may be associated with transactional sex (e.g., if a young woman is using the gifts and money obtained
through transactional sex to support her education). While we are uncertain as to which of the two
directions suggested by the literature would prevail in these analyses, it was unanticipated that there
would be no significant effects of in-school status. However, two opposing forces operating through
girl’s enrollment status may cancel each other out, or the relatively low percentages of young women inschool at the time of the interview as shown in Table 4 may not allow these analyses to detect an effect.
4
As expected, marital status is an important determinant of transactional sex. Married women in all 12
countries are significantly less likely to engage in transactional sex than single women. The magnitude of
the difference in the odds of engaging in transactional sex between ever-married and never married
women varies widely across countries. In six countries (Guinea, Kenya, Niger, Nigeria, Togo, and
Zambia), the odds of ever-married women engaging in transactional sex are at least 80 percent less than
never married women. Among the remaining six countries, four (CAR, Chad, Mali, and Zimbabwe) had
a difference in the odds ratios of approximately 60 percent, whereas in Benin and Burkina Faso the
magnitude of the difference in the odds between never married and ever-married was smaller, with the
odds of an ever-married women engaging in transactional sex to be 50 percent and 30 percent lower,
respectively.
The relationship between household economic status and sexual exchange is not consistent across
countries. In Burkina Faso, the odds of women from households with a low SLI scores to engage in
transactional sex are 118 percent higher than those from households with high SLI scores; and in Togo,
the odds ratios indicate that women from households with medium SLI scores are 68 percent more likely
to be involved in sexual exchange than are women from wealthier households. However, in Mali and
Nigeria, women from poor households with low SLI scores are 40 percent and 50 percent less likely
respectively to be involved in sexual exchange as compared with women from households with high SLI
scores. The same inconsistency emerges in the medium SLI category. Women in this category in Niger
are 90 percent less likely to engage in transactional sex as compared with women from households with
the highest SLI scores, the opposite of the direction of the effect for this category in Togo. These results
are statistically significant at the p <0.05 level.
Men and Transactional Sex
Similar to the analyses of the data for women, an initial logistic regression was applied to the entire
sample of sexually active men 15–49 in all the countries. The results of the analysis of the relationship
between age and sexual exchange are consistent with the results for women. As shown in Table 7, in all
of the 11 countries included in the analysis, young men are substantially more likely to report
transactional sex than are men 25 years and older. These results are statistically significant in seven
countries (Benin, CAR, Chad, Guinea, Niger, Togo, and Zambia). In Chad, Guinea, Niger, and Togo,
the odds of men age 15–19 engaging in transactional sex is more than 100 percent those of men 25 years
and older. In Benin, Chad, Togo, and Zambia, 20–24 year old were more than 50 percent more likely to
engage in transactional sex than the men 25 years and older, and in CAR they were 162 percent more
likely to do so than older men.
As with the women, the effects of the other socio-demographic variables were then examined just for
sexually active young men, ages 15–24. The results for the reduced model are presented in Table 8. As in
the case of young women, the relationship between residence and the probability of engaging in sexual
exchange is not particularly strong or consistent across countries. In two of the 11 countries (Chad and
Mali), men living in rural areas are significantly less likely to engage in sexual exchange than urban men.
However, in Niger, men living in rural areas appear to be more likely to be involved in transactional sex.
In three of the 11 countries, religion was found to be a statistically significant predictor of sexual
exchange for young men, but in a quite different direction than that found for young women. In seven of
11 countries, young Muslim men are more likely to be involved in transactional sex than young Christian
men. These results are statistically significant in Kenya and Togo. Young men in the “Other” religion
category were more likely to be involved in transactional sex than Christian men in eight out of the 11
countries, and this result is statistically significant in CAR.
In Togo, young men affiliated with a
traditional religion are significantly more likely to report transactional sex than were young, male
Christians in that country.
5
In-school status emerges as a moderately important factor for young men. In two of the 11 countries,
there are statistically significant odds ratios indicating that young men who are now in school are less
likely than those out of school to be involved in sexual exchange. In CAR and Togo, young males in
school are 50 percent less likely than men who are no longer in school to engage in transactional sex.
However, in Nigeria, young men who are in school are significantly more likely to report transactional
sex although the magnitude of the difference is not large.
Marital status is an important determinant of transactional sex for young men, but not as universally as for
women. In seven of the 11 countries (Benin, Burkina Faso, Chad, Niger, Nigeria, Togo, and Zambia)
married men are significantly less likely to engage in transactional sex as compared with single men.
The relationship between household economic status and sexual exchange is more consistent among
young men than among young women. However, the results run counter to the hypothesis that economic
status is positively associated with engagement in transactional sex. In three countries (Benin, Nigeria,
and Togo), young men from low SLI households are significantly more likely to engage in transactional
sex than those from households with the highest SLI score, while in Togo young men from medium-level
SLI households are also significantly more likely to engage in transactional sex than those in high SLI
households. Because it is not known whether men reporting engagement in transactional sex are giving
or receiving money or gifts, it is difficult to interpret the meaning of this result.
Discussion
The results from the multivariate analysis support the hypothesis that younger women are at higher risk
than are older women. Odds ratios are in the expected direction in 11 of the 12 countries and are
statistically significant in six of the 12 countries. The results for men directly contradict our hypothesis
that older men would be more likely to engage in transactional sex, suggesting that cross-generational and
transactional sex may not be as closely linked as assumed in much of the qualitative literature. This
finding was perhaps the most programmatically important result of this study: young men are at greater
risk of engaging in transactional sex than older men. Thus, interventions need to focus not only on young
women and older men but also on young men.
For the second stage of the analysis (sexually active young men and young women 15–24 only), the
hypothesis that sexual exchange is primarily an urban phenomenon is only somewhat supported by the
results for young women, with only three countries providing significant supporting evidence, and two
countries contradicting our hypothesis. Similarly for young men, only two of the 11 countries provided
supporting evidence.
Religion is likely a measure of social norms and expectations for both men and women. It is interesting
that while Muslim religious affiliation seems to significantly reduce the risks of transactional sex for
women, it increases the risks for men.
Surprisingly, the results do not support the hypothesis that in-school status makes women less likely to
engage in transactional sex, although as mentioned earlier, it is possible that being in school could work
in two opposite ways. However, neither of the hypothesized effects were manifested in any country in the
analyses for young women, which suggests in-school status is not very important in understanding
transactional sex. In nine of the 11 countries, in-school status had no statistically significant protective
effect on young men and transactional sex. This is a disappointing finding from the programmatic
perspective because it appears in-school status does not reduce the risk of engaging in transactional sex
for young men and young women.
6
Marriage is a strong predictor for not having engaged in transactional sex for young women and for
young men, although the effect on young women was found in all of the countries compared with seven
of 11 countries for young men. However, it was anticipated that marriage would be a greater constraint
for women than men, giving social norms in some countries that view multiple partners for men,
including ones outside of marriage, as appropriate expressions of masculinity.
The results relating to the relationship between economic status (SLI score of the household) and
transactional sex were unexpected for both women and men. While in two countries (Burkina Faso and
Togo) women living in households with low or mid-level SLI scores were more likely to engage in
transactional sex, in two other countries (Mali and Nigeria), women from the poorer households appeared
to be less likely to be involved in transactional sex. In three countries (Benin, Nigeria, and Togo), men
from lower SLI households were more likely to engage in transactional sex. If it is assumed that the
majority of men responding affirmatively to the question were giving, and not receiving, gifts or money,
this finding is very puzzling. On the other hand, if a large proportion of young men are receiving money
or gifts in exchange for sex, this finding is plausible.
Thus, the central finding of this study is that both unmarried young women and young men are at
increased risk for engaging in transactional sex. In-school status, place of residence, and economic status
of the household do not appear to influence the probability that a young person will engage in
transactional sex. Thus, programs will need to focus on unmarried young men and women across the
board, although messages will need to be refined for each group. Programs can be geared to prevent
transactional sex or protect youth involved in transactional sexual relationships.
Prevention of Transactional Sex
Because the findings on standard of living are not consistent, it is unclear to what extent providing young
girls and women with income-generation opportunities may make them less inclined to engage in
transactional sex. Some evidence suggests that income from income-generation interventions may simply
be used to supplement income from transactional sex (Parker, 2002). However, the additional income
from income-generation activities may be instrumental in making girls less dependent on a transactional
sexual relationship. If a woman feels less reliant on a relationship that includes transactional sex, she may
be better positioned to negotiate condom use and timing of sex. The Shaping the Health of Adolescents
in Zimbabwe (SHAZ) program provides education and vocational training, as well as micro-credit loans
in order reduce the chances that young women will engage in risky sexual behaviors, including
transactional sex. This program is being closely followed, so the results from the program evaluation
should provide information relating to effectiveness of this type of intervention (Chase, 2004).
Some organizations in Africa are mounting communication campaigns to make young girls aware of the
risks of engaging in transactional sex (Berman, 2002). Some limited evidence has suggested that
behavior change communication (BCC) programs such as the university program and the “Girls Power
Initiative” in Nigeria have shown that BCC interventions reduce the likelihood that young women will
engage in transactional sex (Luke, 2001).
The literature suggests that parental guidance and/or pressure may influence transactional sex, especially
in the case of young women. Parents may not realize that they implicitly encourage transactional sexual
behavior by pressuring their children to be married or to support themselves. Conversely, a parent who
fails to take an active part in his/her child’s relationships may fail to prevent the child’s risky sexual
behavior. Behavior change communication campaigns that are sensitive to strong social and cultural
norms supporting the relationship between parent and child in Africa may make parents more aware of
the risks of transactional sex and encourage them to be more involved in their children’s decisions.
7
There have been few interventions targeting young men who may be receiving gifts or money in a
transactional sexual relationship. One unanswered question is: how pervasive is the acceptance of gifts
and money in exchange for sex among young men in sub-Saharan Africa? Evidence from this paper
suggests that this may be a larger problem than previously assumed.
There is limited information regarding the cost and effectiveness of interventions to prevent transactional
sex among youth. Governments, donors, and nongovernmental organizations need more information of
this type to guide program planning.
Protecting Youth Involved in Transactional Sexual Relationships
Even if they are unwilling or unable to cease involvement in transactional sexual relationships, young
women and young men may be willing to take measures that reduce the health risk of engaging in this
behavior, by using condoms. However, because young girls are less likely to be able to negotiate the use
of condoms when there is transaction of money or gifts involved in the relationship, programs should
target men involved in transactional sex to persuade them to use condoms. Information, education, and
communication campaigns should be mounted that acknowledge the existence of transactional sexual
relationships and speak bluntly about the risks involved. Programs should be designed to build up self
esteem and empower young women and young men to make healthy life decisions. Role playing and
hands-on exercises may be effective tools for improving young women’s negotiating skills. Similarly,
messages and programs should be crafted to help young men protect themselves and their current and
future partners when they enter into transactional sexual relationships.
Being in school does not appear to provide protection against engaging in transactional sex. Therefore,
campaigns to discourage transactional sex must be targeted to in-school and out-of-school young people
alike. However, it is still important to examine the effects of education in other ways than this study has
such as whether the total years of education reported by a young woman or young man affects the
likelihood of engaging in transactional sex.
For young people who do engage in transactional sex, policies and programs should make condoms and
other contraceptives accessible. Only in this way will transactional sex not lead to unwanted pregnancy
and transmission of STIs including HIV.
8
Appendix Tables
Table 1. Percentage of sexually active women and men ages 15–49 in 12 sub-Saharan African
countries by age group
Women
Men
Country
15–19
20–24
25+
Total
15–19
20–24
25+
Total
E/S Africa
Kenya
42.8
88.4
99.3
83.9
56.0
92.3
99.4
87.6
Zambia
59.7
95.4
99.7
88.9
67.7
90.9
99.4
89.7
Zimbabwe
32.4
85.5
99.3
80.3
NA*
NA*
NA*
NA*
West Africa
Benin
54.0
94.8
99.1
90.2
NA**
Burkina Faso
47.4
95.5
99.8
87.0
29.5
CAR
61.8
96.9
99.6
90.8
51.1
Chad
55.1
94.7
99.6
88.4
37.2
Guinea
59.8
93.9
99.7
90.8
52.3
Mali
66.4
96.8
99.7
92.6
37.1
Niger
57.5
88.0
99.2
87.4
24.4
Nigeria
43.3
84.1
98.4
78.0
26.9
Togo
59.4
96.0
99.8
90.9
39.6
*1994 Zimbabwe DHS does not include transactional sex question for men
**1996 Benin DHS does not include 15–19 age group for men
Country
E/S Africa
Kenya
Zambia
Zimbabwe
West Africa
Benin
Burkina Faso
CAR
Chad
Guinea
Mali
Niger
Nigeria
Togo
87.9
72.0
93.8
79.7
84.9
77.1
63.5
64.4
84.6
Table 2. Sample sizes for logistic regression analyses:
Men/Women 15–49, Men/Women 15–24
Women
Men
15–24
15–49
15–24
99.4
97.4
98.9
98.1
99.1
98.3
98.4
97.1
99.0
15–49
2,155
2,923
1,533
6,612
7,128
4,920
1,015
669
NA*
2,808
1,537
NA*
1,535
1,829
1,879
2,263
1,833
2,853
2,233
2,054
2,449
4,951
5,610
5,342
6,593
6,135
8,984
6,621
6,871
7,787
255**
472
418
490
457
391
526
341
883
1,225**
1,791
1,355
1,735
1,514
1,783
2,330
1,712
2,873
*1994 Zimbabwe DHS does not include transactional sex question for men
**1996 Benin DHS does not include 15–19 age group for men
9
97.3
78.2
89.4
82.0
87.7
84.7
76.8
79.9
82.9
Table 3. Percentage of sexually active women and men reporting exchange of sex for money or
other gifts in the last 12 months in 12 sub-Saharan African countries
Women
Men
Country
15–19
20–24
25+
Total
15–19
20–24
25+
Total
E/S Africa
Kenya
13.5
7.9
5.1
6.7
17.6
20.9
16.4
15.4
Zambia
26.6
12.3
6.0
11.0
40.0
34.3
16.5
24.7
Zimbabwe*
7.3
4.1
2.9
3.6
NA**
NA**
NA**
NA**
West Africa
Benin
13.8
4.1
1.9
3.7
NA***
29.8
Burkina Faso*
8.3
1.2
0.8
1.8
26.1
22.3
CAR
6.8
5.8
2.8
3.8
17.9
22.3
Chad
5.3
2.4
1.9
2.5
48.4
31.7
Guinea
6.6
4.6
2.9
3.7
10.3
5.5
Mali
13.2
8.0
4.7
6.5
21.1
23.6
Niger
2.0
2.2
1.4
1.6
40.1
21.0
Nigeria
13.0
8.5
3.4
5.5
26.8
17.2
Togo
9.3
3.3
.8
2.4
14.3
12.4
*DHS reports transactional sex in last four weeks
**1994 Zimbabwe DHS does not include transactional sex question for men
***1996 Benin DHS does not include 15–19 age group for men
15.8
6.5
8.2
11.3
3.7
6.1
7.0
10.3
5.0
18.2
10.5
11.5
18.1
4.7
9.2
11.0
12.1
7.3
Table 4. Percentage of sexually active women and men in school in 12 sub-Saharan African
countries
Women
Men
Country
15–19
20–24
25+
Total
15–19
20–24
25+
Total
E/S Africa
Kenya
22.5
3.2
0.0
3.4
47.7
8.4
0.2
9.1
Zambia
14.8
1.5
0.0
2.8
43.9
7.2
0.0
9.8
Zimbabwe
5.2
2.3
0.0
1.0
NA*
NA*
NA*
NA*
West Africa
Benin
8.5
2.2
0.0
1.4
NA**
12.9
Burkina Faso
5.7
3.9
0.1
1.6
20.5
7.4
CAR
11.2
5.7
0.0
2.8
33.3
18.4
Chad
7.5
4.2
0.4
2.2
52.7
32.4
Guinea
9.1
4.9
0.0
2.0
53.9
25.7
Mali
8.8
3.0
0.0
1.8
34.3
16.0
Niger
0.5
0.7
0.0
0.2
19.3
7.2
Nigeria
20.7
11.6
0.0
4.8
49.3
27.0
Togo
28.5
7.8
0.0
5.2
59.6
29.6
*1994 Zimbabwe DHS does not include transactional sex question for men
**1996 Benin DHS does not include 15–19 age group for men
10
0.0
0.1
0.0
3.3
0.0
0.1
0.1
0.6
0.2
2.2
2.9
6.5
12.7
10.1
4.5
2.2
5.6
11.7
Table 5. Estimate of the relative odds of exchange of sex for money or gifts as a function of various individual level socio-demographic characteristics among
women age 15–49 in 12 sub-Saharan African countries
E/S Africa
West Africa
Kenya
Zambia
Zimbabwe
Benin
CAR
Guinea
Mali
Nigeria
B. Faso
Chad
Niger
Togo
Variable
(6,612)
(7,128)
(4,920)
(4,951)
(5,610)
(5,342)
(6,593)
(6,135)
(8,984)
(6,621)
(6,947)
(7,787)
(N)
AGE
15–19
1.16
2.11***
1.61*
1.95**
5.20***
1.44
.91
1.12
2.09***
1.45
1.37
3.57***
.99
1.54***
1.16
1.09
1.40
1.40
.78
1.05
1.44**
1.06
1.10
1.95**
25+ (ref)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
RESIDENCE
Urban (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.37***
.98
.99
.71
1.26
.51**
.66
.76
.37***
.24***
2.41***
.66*
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.85**
.00
.80
1.10
.39*
1.44*
.55**
1.09
.53
.47***
.67
.62
1.34
20–24
Rural
RELIGION
Christian (ref.)
Muslim
Traditional
Other
.98
1.00
.81
.83
.86
1.02*
.95
.97
1.00
1.00
1.00
1.00
1.09
.75
.79
.79
5.49***
.00
.61
.83
.27
1.09
1.06
1.01
.96
1.18
1.03
.84
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.31***
.04***
.17***
.44***
.12***
.09***
.15***
EDUCATION
In-school
Out of school (ref.)
MARITAL STATUS
Ever Married
Never Married (ref.)
.20***
.18***
.31***
.09***
.14***
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Low
1.15
1.15
1.00
1.25
2.23**
.62*
.90
.71
.59***
.67
.47***
1.33
Medium
1.18
1.56**
.88
1.28
1.52
.81
.62
1.14
.87
.49
.88
1.74*
High (ref.)
1.00
1.0
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
SLI
1.0
* p < .05; ** p < .01, *** p < .001
11
Table 6. Estimate of the relative odds of exchange of sex for money or gifts as a function of various individual level socio-demographic characteristics
among women age 15–24 in 12 sub-Saharan African countries
E/S Africa
West Africa
Kenya Zambia Zimbabwe
Benin
CAR
Guinea
Mali
Nigeria
B. Faso
Chad
Niger
Togo
Variable
(2,155) (2,923)
(1,533)
(1,535)
(1,829)
(1,879)
(2,263)
(1,833)
(2,853)
(2,233)
(2,130)
(2,449)
(N)
RESIDENCE
Urban (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.42***
1.12
1.03
.91
3.33**
.39***
.90
.57
.44***
.45
2.45***
.79
Christian (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Muslim
1.69
1.00
.77
1.08
.09*
.92
.35***
.81
.82
.44***
.69
1.025
1.21
Rural
RELIGION
Traditional
Other
.41
.93
1.10
1.423
In-school
.87
1.01
.96
1.02
Out of school (ref.)
1.00
1.00
1.00
.20***
.15***
1.00
Low
1.31
.77
.32
.55
3.83**
.00
2.09
1.07
.35
1.87
1.06
1.00
1.00
1.23
1.03
.91
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.30***
.50***
.68***
.34***
.39***
.15***
.41***
.12***
.09***
.10***
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.30
.87
.86
1.52
2.18*
.74
.82
.96
.61**
.52
.53**
1.20
Medium
1.17
1.29
.97
1.64
1.20
1.01
.58
1.58
.87
.11*
.99
1.68*
High (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
EDUCATION
MARITAL STATUS
Ever Married
Never Married (ref.)
SLI
* p < .05; ** p < .01, *** p < .001
12
Table 7. Estimates of the relative odds of the exchange of sex for money or gifts as a function of various individual level socio-demographic
characteristics among men age 15–49 in 11 sub-Saharan African countries
E/S Africa
West Africa
Kenya
Zambia
Benin
CAR
Guinea
Mali
Nigeria
B. Faso
Chad
Niger
Togo
Variable
(2,984)
(1,659)
(1,493)
(2,064)
(1,545)
(1,903)
(1,737)
(2,096)
(2,720)
(2,140)
(3,166)
(N)
AGE
15–19
.83
1.63*
N/A
1.08
1.72
2.42***
2.77*
1.00
2.12**
1.20
2.21**
20–24
1.12
1.66**
1.62*
1.23
2.62***
1.86**
1.33
1.50
1.49*
.72
1.53*
25+ (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
RESIDENCE
Urban (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.59***
1.51*
1.09
1.78*
1.07
.61*
1.65
.64*
1.59*
.73
.68*
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.84**
.43
1.23
1.36
.90
.88
1.27
.61
.70
.95
1.80**
1.23
1.03
Rural
RELIGION
Christian (ref.)
Muslim
Traditional
Other
.78
.67
.80
In-school
.99
.89
.97
Out of school (ref.)
1.00
1.00
.50***
Never Married (ref.)
1.65*
3.85**
.85
1.58
1.09
.20
1.86
1.24
.97
.47*
.98
.50
.79
.82
1.07
.47**
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.42***
.45***
.12***
.46***
.24***
.56
.15***
.14***
.32***
.35***
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
SLI
Low
.88
.84
1.57*
1.16
.64*
.60*
.75
.82
.71
1.04
1.16
Medium
.83
.96
1.91**
.90
.91
.77
.79
.67
.89
1.43
1.23
High (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
EDUCATION
MARITAL STATUS
Ever Married
* p < .05; ** p < .01, *** p < .001
13
Table 8. Estimates of the relative odds of the exchange of sex for money or gifts as a function of various individual level socio-demographic
characteristics among men age 15–24 in 11 sub-Saharan African countries
E/S Africa
West Africa
Kenya
Zambia
Benin
CAR
Guinea
Mali
Nigeria
B. Faso
Chad
Niger
Togo
Variable
(1,015)
(669)
(255)
(472)
(418)
(490)
(457)
(391)
(526)
(341)
(883)
(N)
RESIDENCE
Urban (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.87
1.30
1.77
1.77
1.22
.62**
.94
.39**
2.25**
.75
.67
Christian (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Muslim
2.2**
1.44
.61
1.40
.86
1.27
1.92
.75
.89
1.48
1.67*
.72
1.52
Rural
RELIGION
Traditional
Other
.67
1.42
1.52
In-school
.98
.91
.95
Out of school (ref.)
1.00
1.00
Ever Married
.92
Never Married (ref.)
2.04**
12.59*
1.22
2.14
1.71
.34
4.89
1.02
.99
.58*
.97
.66
.82
.79
1.09*
.56*
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
.62*
.40**
.25***
.83
.32***
1.07
.99
.15***
.227**
.30**
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Low
.77
1.22
2.21*
1.46
.75
.87
1.34
1.30
1.30
2.75*
2.12**
Medium
1.05
1.62
3.59**
1.28
1.19
.65
.89
.57
1.09
1.95
1.87*
High (ref.)
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
EDUCATION
MARITAL STATUS
SLI
* p < .05; ** p < .01, *** p < .001
14
References
Ankomah, Augustine. 1998. “Condom Use in Sexual Exchange Relationships Among Young Single
Adults in Ghana.” AIDS Education and Prevention 10(4): 303–316.
Barker, Gary Knaul and Susan Rich. 1992. “Influences on Adolescent Sexuality in Nigeria and Kenya:
Findings from Recent Focus-Group Discussions.” Studies in Family Planning 23: 199–210.
Berman, John. 2002. “Innovations for Adolescent Girls and HIV/AIDS: Addressing Cross-generational
and Transactional Sexual Relations.” Conference sponsored by AIDSMark and AED.
Bledsoe, Carolyn. 1990. “School Fees and the Marriage Process for Mende Girls in Sierra Leone.” Pp.
283–309 in New Directions in the Anthropology of Gender, edited by Peggy Reeves Sanday and Ruth
Gallagher Goodenough.
Calves, Anne Emmanuele, Gretchen T. Cornwell, and Parfait Eloundou Enyegue. 1996. Adolescent
Sexual Activity in Sub-Saharan Africa: Do Men Have the Same Strategies and Motivations as Women ?
University Park, PA: Population Research Institute.
Castle, S. and M.K. Konaté. 1999. “The Context and Consequences of Economic Transactions Associated
with Sexual Relations among Malian Adolescents.” The African Population in the 21st Century:
Proceedings of the Third African Population Conference 2: 105–128. Durban.
Chase, Marylin. 2004. “Saying No to ‘Sugar Daddies’: Can a Financial Prophylactic Shield Girls from
Liaisons That Spread AIDS in Africa?” The Wall Street Journal: February 25, 2004.
Gorgen, Regina, Mohamed Yansane, Michael Marx, and Dominique Millimonunou. 1998. “Sexual
Behaviour and Attitudes Among Unmarried Urban Youths in Guinea. International Family Planning
Prespectives, 24(2): 65–71.
Gregson, Simon, Constance A. Nyamukapa, Geoffrey P. Garnett, Peter R. Mason, Ton Zhuwau, Michel
Carael, Stephen K. Chandiwana, and Roy M. Anderson. 2002. “Sexual Mixing Patterns and SexDifferentials in Teenage Exposure to HIV Infection in Rural Zimbabwe.” The Lancet 359: 1896–1903.
Hulton, Louise A., Rachel Cullen, and Symons Wamala Khalokho. 2000. “Perceptions of the Risks of
Sexual Activity and Their Consequences Among Ugandan Adolescents.” Studies in Family Planning
31(1): 35–46.
Kaufman, Carol E., Thea de Wet, and Jonathan Stadler. 2001. “Adolescent Pregnancy and Parenthood in
South Africa.” Studies in Family Planning 32(2): 147–160.
Longfield, Kim, Anne Glick, Margaret Waithaka, and John Berman. 2002. “Cross-Generational
Relationships in Kenya: Couples’ Motivations, Risk Perception for STIs/HIV and Condom Use.”
Working Paper No. 52. Washington, DC: PSI Research Division.
Luke, Nancy. 2001. “Cross-generational and Transactional Sexual Relations in Sub-Saharan Africa: A
Review of the Evidence on Prevalence and Implications for Negotiation of Safe Sexual Practices for
Adolescent Girls” Paper prepared for the International Center for Research on Women as part of the
AIDSMark Project.
15
Machel, Josina Z. 2001. “Unsafe Sexual Behavior Among Schoolgirls in Mozambique: A Matter of
Gender and Class.” Reproductive Health Matters 9(17): 82–90.
Meekers, Dominique and Anne-Emmanuele Calves. 1997. “‘Main’ Girlfriends, Girlfriends, Marriage,
and Money: The Social Context of HIV Risk Behaviour in Sub-Saharan Africa.” Health Transition
Review 7(Supplement): 316–375.
Mensch, Barbara S., Judith Bruce, and Margaret E. Greene. 1998. The Uncharted Passage. Girls’
Adolescence in the Developing World. New York: Population Council.
Nyanzi, S., R. Pool, and J. Kinsman. 2001. “The Negotiation of Sexual Relationships Among School
Pupils in South-western Uganda.” AIDS Care 13(1): 83–98.
Nzioka, Charles. 2001. “Dealing with the Risks of Unwanted Pregnancy and Sexually Transmitted
Infections Among Adolescents: Some Experiences from Kenya.” African Journal of Reproductive Health
5(3): 132–149.
Nzyuko, Solomon, Peter Lurie, William McFarland, Wendy Leyden, David Nyamwaya, and Jeffrey
Mandel. 1997. “Adolescent Sexual Behavior Along the Trans-Africa Highway in Kenya.” AIDS
11(Supplement 1): s21–s26.
Parker, Joan. 2002. “Reducing the Pressure for Cross-generational Sex Through Economic Strengthening
Interventions.” Presented at conference entitled “Innovations for Adolescent Girls and HIV/AIDS:
Addressing Cross-generational and Transactional Sexual Relations,” hosted by ICRW and PSI on
September 10, 2002.
Silberschmidt, Margrethe and Vibeke Rasch. 2001. “Adolescent Girls, Illegal Abortions and “Sugar
Daddies’ in Dar es Salaam: Vulnerable Victim and Active Social Agents.” Social Science and Medicine
52: 1815–1826.
Temin, Miriam J., Friday E. Okonofua, Francesca O. Omorodion, Elisha P. Renne, Paul Coplan, H. Kris
Heggengougen, and Joan Kaufman. 1999. “Perceptions of Sexual Behavior and Knowledge about
Sexually Transmitted Diseases Among Adolescents in Benin City, Nigeria.” International Family
Planning Perspectives 25(4): 186–190, 195.
16